Medical Insurance & Medical Aid: The Difference

Product info

In short: The biggest difference is the price and what is covered. Let's explain.

The longer version:

Health insurance (like what GetSavvi Health offers) is commonly more affordable and provides day-to-day cover, consisting of routine doctors’ visits, dental care and preventative benefits, an approach that addresses overall well-being.

In contrast, medical aid concentrates on specific treatments such as specialised care, in-hospital procedures, and cover of Prescribed Minimum Benefits (PMBs).

Health insurers frequently offer additional services unrelated to healthcare, such as funeral cover and member wellness support, providing a more holistic approach to a member’s health.

The even longer version:

Medical Insurance

Simply put, medical insurance covers or insures individuals against the risk of incurring medical expenses and is governed by The Financial Services Act.

Let’s explore more features of medical insurance below:

 Features of Medical Insurance

  1. Focuses on providing day-to-day, preventative benefits, and limited specialist services which makes medical insurance a much more affordable option.
  2. May be used in conjunction with medical aid to cover your day-to-day medical costs so that you can save on your medical aid in the long run.
  3. Cover for the whole family is usually at a fixed premium, so whether you have one dependant or four, your premium would stay the same.
  4. Because medical insurance is governed by The Financial Services Act, many schemes are able to offer other benefits like death or funeral cover.
  5. Covers treatment at fixed amounts paid on behalf of the member.
  6. May or may not cover prescribed minimum benefits (PMB).

Medical Aid

Medical aid is a plan that allows you medical care without financial burden should something unexpected happen and you need hospitalisation or extensive specialist care. Medical aid is governed by The Council for Medical Schemes and regulated by the Medical Schemes Act.

Features of a Medical Aid

  1. Provides cover for day-to-day care as well as more comprehensive cover like hospitalisation and specialist care.
  2. Prices increase as more dependants are added which can skyrocket your monthly premium.
  3. Medical aids must, by law, cover PMB.
  4. Doesn’t include cover for any personal accidents, disability and/or loss of limbs.
  5. Isn’t authorised to include death and/or funeral cover as part of the medical aid cover.
  6. Is required to pay in-hospital benefits according to the National Recommended Price List which limits the benefits as per the medical aid plan.

Can I get health insurance alongside my medical aid?

Yes. Health insurance is an excellent option for individuals who have medical aid but may not be entirely satisfied with their day-to-day medical benefits (GP visits, dentistry and acute medication, etc.).
Certain individuals opt for medical aid and complement it with health insurance to cover them for everyday medical expenses.

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If you're interested in joining a health insurer like GetSavvi Health and want to find out more about our plans and prices, simply click here to get a quick quote and request a call back to talk to a consultant.